‘The rheumatologist has exhausted all the possibilities in his repertoire?’
‘Yes, Pippa’s had just about all medical treatments available. Even a course of injections of an experimental anti-metabolite. They worked for a while, but her liver started showing signs of stress.’ Tara extracted a radiology report from the file. ‘This is her latest X-ray report.’ She paused as Ryan took the two sheets she handed him, containing a long and detailed assessment. ‘The patient has the original films, but I’ve asked Pippa to bring her most recent X-rays when she comes to see you.’
Ryan was silent and his face immobile as he read the report. It was impossible to tell what he was thinking. Finally he looked up, his expression bleak.
‘She’s only nineteen. Poor kid,’ he said softly as his brow furrowed into a frown.
‘They’re awful, aren’t they? Her left hip is nearly as bad.’
Ryan nodded. ‘About as bad as I’ve seen in someone so young.’ He hesitated, closing his eyes and rubbing his forehead as if attempting to erase what he’d seen in the X-ray report. He took a deep breath as he opened his eyes. ‘You know I mainly see adults?’
‘Pippa is an adult. And a beautiful young person who has had to grow up fast,’ Tara couldn’t help adding. Against all that she’d been told in her training, Tara had developed a bond with Pippa that went beyond the usual relationship between doctor and patient. Their connection was all about shared disabilities which had robbed them of many things healthy, able-bodied people took for granted. Tara understood exactly what her young patient was going through. No matter how much they strived to live a normal life they would always be considered different, and often a burden to those who cared for them. And Pippa was a teenager, with all the baggage associated with her stage in life—the transition from childhood to adulthood; the need to be accepted by peers; rebellion against parental control; preoccupation with appearances and the related issues involving self-esteem, making choices about her future. The list was endless.
‘You know what I mean,’ Ryan answered.
‘Sorry, of course I do. Anyone under fifty is young when it comes to considering a hip prosthesis.’
‘Just based on the report, she must have a high level of pain and loss of joint function. And I agree the left hip doesn’t look too great either.’
‘The pain is the deciding factor for her. Some days it’s an ordeal to get up in the morning, and her slow, stiff movements are more to do with the fact her joints are hurting so much than limitation due to the disease.’
‘Quality of life?’ Ryan asked with a sigh.
‘She finished Year Twelve last year—amazing to be only a year behind her peers when she’s had so much time off. She gained the marks to get into uni and has enrolled in a teaching degree at Bayfield.’
Ryan leaned back in his chair and studied the report again.
‘Remarkable. She must have good family support. Even travelling for a couple of hours a day must be difficult.’
‘Her father’s principal of the local high school and her mother’s a pre-primary teacher.’ Tara smiled at the recollection of Pippa’s stubbornness in her insistence she embark on a career in teaching. Tara suspected teaching was in her blood, and she had encouraged the young woman to pursue her dream by example. Nothing was impossible if you wanted it enough. ‘Her father has organised for a lot of her coursework to be done online, so she only has to travel one or two days a week. The last six months, when the rheumatoid has been really active, she’s resorted to using a wheelchair a few times.’
‘A wheelchair?’ Ryan’s eyebrows elevated.
Tara nodded. ‘Only as a last resort. She’s really tried hard to overcome her condition, and considering her age—’
‘She has her whole life ahead of her.’
‘Exactly.’ Tara fiddled with the hem of her blouse for a moment, suddenly overcome with emotion at the thought of what Pippa had gone through and the future that lay ahead. ‘Do you think a hip replacement is an option?’
‘Without seeing her, my thoughts are that surgical treatment would be effective in getting rid of her pain, and would probably restore mobility to the joint…’
‘But?’
Tara could tell he had doubts.
‘But she’s so young. Even with the latest prosthesis, and the possibility of replacing the joint without cement, she’d be lucky to get twenty years out of a new joint. The best scenario would be that she’d be in her forties and need surgery again.’
Tara hesitated before voicing her own thoughts.
‘Twenty years without pain is better than twenty years of agony. That’s my personal opinion.’
* * *
Tara’s simple statement cut to Ryan’s core, and the few moments’ silence seemed to stretch way too long. Her face was serious and Ryan tried to read her thoughts.
Was she talking, just a little, about herself?
Eventually he spoke.
‘She’s a little like you, isn’t she?’
Tara fidgeted, and then looked up straight into his eyes with poignant honesty. She cleared her throat.
‘Maybe a bit.’
‘Was I part of your pain?’
Ryan could see the pulse in her neck and it was accelerating.
‘I don’t understand what you mean?’
He decided to be brutally direct. There were still things about the accident and the aftermath he didn’t understand.
‘Removing me from your life lessened your pain, helped you cope?’
‘In a way,’ Tara said in barely more than a whisper. ‘I’d lost so much…Having to deal with your distress and uncertainty as well as my own was just as bad as the somatic pain of my injuries. Can you understand that?’
Ryan nodded, swallowing the lump that had lodged in his throat.
She continued. ‘I’m sorry if I hurt you, but it was for a reason. In some ways the divorce was a relief. The last thing I wanted was for you to stay with me out of guilt or duty.’ She looked away. ‘And I believed you’d stopped loving me, despite your insistence that you’d do anything for me. I was scared witless of messing up both our lives.’
Her eyes were moist but Ryan needed to know.
‘Do you still think that? That I stopped loving you?’
Tara took a deep breath and continued to fix her gaze on the window.
‘I…I don’t know. It’s been eight years. Some of my memories are blurred. We’re both different people with completely different lives compared with back then. It was a shock to see you again. You remarried. You have a child. And I’m coping in the best way I can—better than that, I am succeeding. If we’d stayed together there was no way of predicting if we’d be happy over the long term. I felt the odds were stacked against us.’ She paused. ‘I’m happy with my life now.’
‘Are you?’
‘Of course I am.’
‘How did you feel about me marrying again?’ He hesitated. ‘I couldn’t commit to a new relationship for a long time. It was over three years after we split before I met Shannay.’ The question was blunt but Tara didn’t have to answer if it was too painful.
She swung her gaze back to him and said with purpose, ‘I was pleased. It’s what I wanted—for you to find someone else who could provide the happiness that I couldn’t. Someone who could give you the children you always wanted—’
‘The children we always wanted.’
She looked away.
‘That I could no longer provide.’
Ryan knew that wasn’t strictly true, but he wasn’t about to start an argument.
‘I never loved Shannay.’
‘Why did you marry her, then?’
‘I thought I loved her. She was beautiful and charismatic and young. Too young, really. I was still grieving over the accident and losing you. I know that now. Shannay and I weren’t compatible. She got bored with me and she was the one who wanted us to separate.’
‘But what about your daughter? Shannay must love her.’
‘Of course she does. But I sometimes think Shannay’s too…er…flighty to be a good mother.’
Tara looked truly devastated, and Ryan realised he’d said the wrong thing. He remembered how passionate Tara had been about having children. She’d sworn she’d not make the same mistakes as her parents. And he’d believed it could have worked. It wouldn’t have been easy, but if the passion had been there they could have at least tried. He now had a greater understanding of Tara’s reasons for wanting him out of her life at such a momentously traumatic time. It made him want to be there for her now.
And he’d never fallen out of love with her.
Tara rubbed her hands nervously across her thighs.
‘There’s something I need to know, Ryan.’
He remained silent while Tara appeared to be summoning up the courage to go on. She had the hint of tears in her eyes, but bravely fought them back. She swallowed.
‘Why are you here, Ryan? I don’t understand. Why have you chosen to work in Keysdale when you hate the country and with your qualifications and experience could have just about any job for which you applied? To me, opening old wounds serves no purpose, and if you simply wanted to reassure yourself that my life wasn’t in tatters, and you had absolutely no cause to be guilty, a visit or two would have sufficed.’ She sucked in a breath and clenched her hands together in her lap. ‘Why, Ryan? Why have you done this to me?’
Tara’s poignant and emotive outburst had a similar effect to being hit in the guts with a sledgehammer. She thought he had a hidden agenda—which was the last thing he would have dumped on her. He needed to salvage his credibility.
‘I…I…’ But he battled to find the right words. Tara’s tearful gaze didn’t help. ‘I couldn’t really refuse—’
‘I don’t believe that for a minute.’ Tara’s distress had morphed into a look of steely determination. The only answer she would accept would be the truth.
‘Just listen for a minute.’
‘Go on.’ Tara nodded.
‘I’ve only worked for Southern Orthopaedics for just over a year. Before that I was in New Zealand for six months in a specialised lower limb unit. I’m literally the new kid on the block, and I have what the senior partners consider minimal family commitments. It’s almost a rite of passage for a junior consultant to spend time overseas and be seconded to a rural practice. If you refuse you tend to stagnate and you are not considered for the more…er…esteemed—’
‘You mean promotions.’ Tara interrupted. She had been listening intently and seemed to believe him. ‘And the position in Keysdale just happened to come up?’
‘The past…our history…it was purely coincidence…’
With a decent lashing of fate.
Tara’s hands relaxed and she rubbed one forearm with her other hand.
‘You’ve never been good at lying, Ryan, so I doubt you’d have made it up.’ She gathered together Pippa Morgan’s notes. ‘I believe you.’
She began to lift herself on to her wheelchair.
‘It’s time for me to go home.’
She looked tired and stifled a yawn.
‘Can we at least be friends?’ Ryan said with apprehension. He had no idea whether he had gained any ground with Tara.
She looked at him with a penetrating gaze but said nothing.
‘Right, then. I’ll help you put the chair into the car.’
* * *
Tara positioned herself comfortably in the driver’s seat and as soon as Ryan had loaded the chair reversed and set off down the road at a speed just short of burning rubber. On the way she glimpsed the local mechanic’s van and the old wreck the garage staff used for pick-ups and deliveries heading for the Riverside. Ryan’s hire car, no doubt. She chuckled. But it wasn’t her problem.
The return of her ex-husband into her life was, though. No matter how hard she tried she couldn’t clear him from her thoughts.
Removing the man she’d once loved from her life had been a major contribution to deadening the emotional pain resulting from the loss of many of the things that had been important to her—her physical strength and agility, her independence, her attractiveness. The biggest blow, though, had been to her self-esteem.
Now Ryan was back he’d rekindled some of those feelings that belonged in the past. Feelings that went deeper than a platonic friendship, than simple physical attraction.
She felt the same intimate connection they’d shared before the accident—the ability to know what the other was thinking, the desire to comfort when the other was hurting, the yearning for mutual happiness and the sharing of goals in a future that stretched until death us do part.
Was that love?
It wasn’t worth even trying to answer the question. Even if it was, loving Ryan again would almost certainly mean more pain. There were too many reasons why the relationship wouldn’t…couldn’t work. Geography, lifestyle and a small child who had probably had more disruption in her life than most adults.
She wished she could believe the old saying that love conquers all, but she had a feeling a future with Ryan now would be more likely to fail than eight years ago. Both she and Ryan had new and different lives, and it was dangerous to even think about taking risks.
She’d just have to work harder at making sure her heart was impenetrable.
There was no point in falling for this intelligent, charming, sensitive man all over again even though she could feel it happening. An attraction based on the past could only lead to disaster. She had to nip her feelings in the bud before they began to blossom.
* * *
Tara was surprised her mother and father didn’t come out to meet her, so she honked her horn twice—the signal she used to alert them she was home. A few minutes later Jane appeared in the doorway, a worried expression on her face, and Tara prepared herself for the inevitable grilling.
‘Thank God you’re home,’ Jane said as she opened the car door. It certainly wasn’t the greeting Tara was expecting. Had something happened? Some bad news?
‘What’s the matter, Mum?’
‘It’s your father. He’s had an accident and he’s refusing to go to the hospital.’
Tara’s heart began to thud irregularly, and she felt the blood drain from her face, but the light-headedness only lasted a few seconds. It was at times like this she missed being able to leap out of the car and run inside. The wait for her mother to get her chair so she could go in and see for herself what had happened was an agony of uncertainty.
‘What happened?’ She couldn’t help the impatient note in her voice.
‘Darby was in one of his bad moods,’ Tara’s mother said breathlessly as she wheeled the chair from the back, not bothering to close the door. ‘And today your father wasn’t quick enough to get out of the way. He’s got a chunk out of his leg, and I think he’s either badly sprained or broken his wrist.’
Tara processed the information as she lifted herself out of the car.
Darby, a now aging pony, had been a gift for Tara’s eighth birthday and she had loved him to bits—still did. He’d probably been a substitute for the siblings she’d never had, and she’d treasured the solitary rides they’d shared when she’d chatter away to him and reveal her deepest secrets.
He’d been literally put out to pasture since Tara had stopped riding him, and was usually placid. Over the last six months or so he’d been prone to stubbornness and the occasional temper tantrum where he’d kick and try to buck. Tara had laughingly said he had equine Alzheimer’s. She doubted he’d be capable of causing any major damage, though.
Her mother, casting worried looks in Tara’s direction, led the way into the house and Tara followed her to the kitchen.
It took Tara only a few seconds to take in the blood-soaked towel on her father’s shin and the roughly applied elastic bandage on his left wrist. Graham’s expression was a mix of frustration, pain and anger.
‘It’s not as bad as it looks,’ he said in an unusually quiet voice, do
ing his best to hide a grimace. ‘Blasted horse,’ he added, as if apportioning blame made it easier for him to cope.
‘Let me have a look.’ Tara wheeled over to where her father sat in a spindle-backed chair next to the kitchen table. ‘Are you in a lot of pain?’
Tara could tell he was, but he was unlikely to admit it. It was one of those crazy man things, to deny pain.
‘Just a bit. Mainly in my leg,’ he said through clenched teeth.
Tara carefully removed the towel from her father’s leg and it took a great deal of effort to suppress her gasp.
A chunk of flesh the size of the palm of her hand had been torn away from his shin just below the knee, exposing bone and muscle. There was no deformity, so she hoped the bones were intact. Her mother had obviously cleaned the edges of the wound as best she could, but there were flecks of dirt and possibly manure embedded in the exposed area and a steady ooze of blood from one side of the wound. For his leg alone he needed X-rays, cleaning and debridement of the wound, a tetanus booster and antibiotics. There was a real possibility he would need a skin graft.
Tara took the clean towel her mother offered and covered the wound, instructing her to apply pressure while Tara began to unwind the bandage. To her relief, the skin of Graham’s hand wasn’t broken, and again there was no obvious deformity, but there was some swelling of his wrist.
‘How did you do this?’ she asked calmly.
Her father seemed to have succumbed to his fate and replied meekly, with what she thought was a hint of a smile on his face, ‘I tried to give Darby the same as he gave me.’
Tara thought for a second.
‘You mean you tried to kick an elderly pony that was having a temper tantrum?’
Her father nodded. Why didn’t that surprise her?
‘And I slipped,’ he added.
‘And landed on your outstretched hand?’
‘Yeah, that’s right.’
He winced as she prodded the dip in the back of his hand near the base of his thumb—over his scaphoid bone.
The Doctor, His Daughter and Me Page 5